Evaluating the risk of malignancy in adnexal masses: validation of O-RADS and comparison with ADNEX model, SA, and RMI

Abstract

Objectives: To evaluate the diagnostic value of Ovarian-adnexal Reporting and Data System (O-RADS), and to compare it with Assessment of Different NEoplasias in the adnexa (ADNEX) model, subjective assessment (SA), and risk of malignancy index (RMI) in differentiating benign and malignant adnexal masses (AMs).Material and methods: Ultrasound characteristics of 445 patients included in the study were retrospectively analyzed and evaluated using diagnostic models. The diagnostic performances of ultrasound diagnostic models were measured by assessing, receiver-operating characteristic curves, sensitivities, positive predictive values, positive likelihood ratios, specificities, negative predictive values, and negative likelihood ratios. Kappa values were used to evaluate inter-reviewer agreement (IRA).Results: Of the 445 AMs, 265 were benign and 180 were malignant. The area under the curve (AUC) of O-RADS (0.941), ADNEX model (0.925), and SA (0.931) were higher than RMI (0.815) (all p < 0.05). The sensitivity of O-RADS (93.3%), ADNEX model (94.4%), and SA (96.1%) were higher than RMI (70.6%) (p > 0.05), and there was no statistical significance among them (p > 0.05). The specificity of O-RADS, ADNEX model, SA, and RMI was 90.2%, 90.6%, 90.2%, and 92.5%, respectively, with no statistical significance (p > 0.05). All four ultrasound diagnostic methods showed better IRA.Conclusions: O-RADS, ADNEX model and SA have better diagnostic value in differentiating benign and malignant AMs than RMI.

Comparison of O-RADS with the ADNEX model and IOTA SR for risk stratification of adnexal lesions: a systematic review and meta-analysis

“…For this meta-analysis, all the studies included had a retrospective study design, with eight studies reporting a head-to-head comparison between O-RADS and the ADNEX model ( 21 , 23 – 28 , 31 ) and seven studies reporting a direct comparison between O-RADS and IOTA SR (including three studies performing a comparison between all three guidelines) ( 20 , 22 , 23 , 25 , 29 – 31 ). The study sample ranged from 122 to 1,179 patients, with an average age of 35–52.3.…”

“…For the patient selection domain, five studies had an unclear risk of bias because of two high malignancy rates ( 20 , 23 , 25 , 28 , 29 ). In three studies, the details on blinding were not provided or reported whether readers have partial knowledge of patient information, thus were assigned an unclear risk of bias in terms of index domain ( 22 , 23 , 28 ). Supplementary Tables S1, S2 show the details of the quality assessment using QUADAS-2 and QUADAS-C.…”